Various painful and pathological conditions can be attributed to poor posture as it relates to the thoracic spine. The poor posture of the thoracic spine may be in the form of increased thoracic kyphosis, an abnormal rearward curvature of the spine, with accompanying forward depressed shoulders.
One of the conditions associated with poor posture is referred to as the thoracic outlet syndrome. In this condition, neurovascular structures are irritated during passage between the pectoralis minor muscle and the coracoid process. The condition is caused by an adaptive shortening of the pectoralis minor muscle as it relates to the postural fault of the particular patient.
Another condition associated with poor posture is chronic mid-back pain. This painful syndrome is directly related to a slow gradual strain to the middle and upper back musculature. A prolonged postural fault will eventually lead to an adaptive stretching of the middle and lower trapezius muscles, as well as a shortening of the pectoralis minor muscle.
Various conventional devices have been utilized in order to address faulty thoracic posture. The most common corrective device is the use of a brace. However, the usage of such a support system to hold the shoulders of a patient back has not proven to be effective over long periods of time. With the accompanying straps and harness, a shoulder brace may reduce some of the symptoms associated with mid-back strain, but such devices typically do not serve to correct the poor posture. In fact, the use of such support systems may further weaken the middle and lower trapezius muscles as they reduce the workload normally associated with these muscles. Furthermore, due to the degree of discomfort required in order to support a patient's forward depressed shoulders with such a strapping system, usage by the patient over a prolonged period of time may not be possible. In addition, due to the strap placement associated with such a support system, it is not uncommon to actually cause further irritation of the neurovascular structure as it passes under the pectoralis minor muscle.
Other attempts have been proposed to improve posture, such as warning devices which sound when a patient begins to conform to a slumping posture. However, such devices are merely palliative rather than therapeutic for correcting such postural faults. Also, many believe that the use of rowing machines, to strengthen the muscles of the middle back, will improve posture. However, the strengthening of the rhomboid muscles with the use of rowing machines actually rotates the glenoid cavity downward and elevates the scapula, which in turn actually worsens the postural fault of forward shoulders and upper back strain.